Utah Workers Compensation Benefits
Workers compensation laws limit the benefits injured workers can receive when they are injured at work. That is right - LIMIT. The Utah legislature chose to protect employers and insurance companies from claims for pain and suffering, loss of earning potential, disability, etc. They did leave you a few benefits. Be sure that every one is paid correctly.
The legislature only protected employers. If someone other than you, your employer or other employees of your employer caused your injury they may not have this protection. If this situation applies to you, contact an attorney to discuss a third party claim. Common situations include: car accidents where the other driver is at fault, faulty machinery or poorly kept premises where the employer does not own the property. (See: Third Party Claims for more information.)
Workers compensation benefits are to be paid if you are injured at work. It does not matter who caused the accident, if you were a temporary employee, if you were out of the state when the injury occurred, or if your employer does not have insurance. With some exceptions, even if you caused the injury, workers compensation benefits are to be paid if the injury occurred at work.
Below is a list of workers compensation benefits with a basic explanation. No explanation can include all possibilities. If you have any questions, contact an attorney for a review of the benefits that apply in your particular circumstances.
All medical expenses related to the injury are to be paid by the workers compensation insurance company. This includes all treatment, prescriptions and prothetics for the injury which is recommended by your doctor. Your right to medical expenses expire if you do not see a doctor and have the doctor submit the bill to the workers compensation insurance company at least every three years.
If your workers compensation claim is denied, you can bill your health insurance for the medical treatment while you file an Application for Hearing with the Labor Commission for workers compensation benefits. (See: Take Action for more information.) However, your benefits for medical expenses will expire if you do not send bills to your workers compensation carrier for a period of three years, so be sure to act quickly whenever benefits are denied.
If your doctor refers you to another doctor, the workers compensation insurance company is also responsible for those medical expenses. Without a referral, you have the right to change doctors one time, but only one time. To change doctors, you must complete a Change of Doctors Form which you can obtain from the Labor Commission.
Mileage to and from the doctor, hospital, chiropractor, physical therapy, etc. is to be paid at the appropriate rate which is currently 34.5 cents a mile. You are required to submit a list of your mileage including the date, doctor's name and number of miles round trip in order to receive this benefit. Your right to mileage expires if you do not submit your request to the workers compensation insurance within a year of the date of the medical visit.
Temporary Total Disability:
If a doctor takes you off work or provides restrictions or limitations and you employer does not offer work that meets those restrictions or limitations, the workers compensation insurance company must pay for the time off work at 66.67% of what you were earning at the time of the injury plus $5 per week for your dependents up to the statutory maximum. Temporary Total Disability ends when you reach medical stability, also called maximum medical improvement or MMI. Temporary Total Disability benefits are available for up to 8 years from the date of the injury. Additional time limits may apply for injuries after July 1, 1999. If it has been over 5 years since your injury and you still need benefits, contact an attorney for the time limits specific to your case.
It is often a good idea to try to avoid surgery and chose conservative treatment. However, if surgery is delayed for more than 8 years from the date of injury, Temporary Total Disability benefits to pay for your time off work may expire. Contact an attorney for the time limits particular to your case and discuss the best options with your doctor.
Temporary Partial Disability:
If a doctor places restrictions on your work which reduce the amount you can earn, but you are able to find light duty work at lower pay the workers compensation insurance company must pay 66.67% of the difference between the amount you are earning and the amount you were earning at the time of the injury plus $5 per week for your dependents. Temporary Partial Disability ends when you reach medical stability or MMI. Just like Temporary Total Disability, your right to claim temporary total disability benefits may expire 8 years from the date of your injury. Contact an attorney to discuss the particular time limits that apply in your case.
Permanent Partial Disability:
If the injury results in permanent injury, your doctor will give you an impairment rating when you reach medical stability or MMI. The insurance company will then pay you based on that impairment rating. Problems can develop if the rating is given too soon. Never pressure your doctor for a rating before you are medically stable.
Please note that under Utah law, no benefits are paid for disability. Instead, Utah uses impairment ratings. Impairment ratings are numbers from the charts in the Guides to Permanent Impairment. The same impairment rating is given to everyone with the same permanent damage, even though the injury may affect some people more than others. For example, a loss of a finger could prevent a typist from being able to do her job while it would not affect an attorney’s ability to work at all. The typist and attorney have different disability levels from the loss of the finger, but they will receive the same impairment rating.
Before paying Permanent Partial Disability, the Insurance Adjuster will send you a "Permanent Partial Disability Agreement" or “Compensation Agreement” for your signature. Your signature on these agreements means that you agree with the impairment rating being paid. It is not a settlement of your claim. Your benefits remain available if you need additional help in the future.
Permanent Total Disability:
If the injury results in an inability to return to work in any past job or other work, Permanent Total Disability benefits may be available which pay a percentage of the lost income for life. This is a complicated area of the law. The law has changed often throughout the years. Legal advice should be obtained to be sure that the requirements associated with your specific injury date are met.
There is no time limit for filing Permanent Total Disability claims for injuries which occurred prior to July 1, 1999. However, cases become more difficult as more time passes. Contact an attorney as soon as possible. For injuries on or after July 1, 1999 proof of Permanent Total Disability must be obtained within 12 years of the date of injury.
If an injury results in death, burial benefits as well as benefits are available for the dependents. In such a serious situation, however, legal advice should be sought immediately.
The dependants of a deceased worker must file a claim for benefits within one year after the death of the employee. However, if a dependant is under 18 years old, a claim must be filed for benefits within one year of turning 18.
This page was written by Atkin & Associates.
Contact attorney Marsha S. Atkin for more information.
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(Chartered April 1, 1988)
The Injured Workers Association of Utah (IWAU) is a Utah non-profit corporation concerned with over 70,000 injured, disabled and displaced workers each year who suffer the financial and personal hardships occasioned by industrial injuries and occupational diseases in Utah. It is neither union nor non-union, and represents all members of the workforce. Its membership is open to all injured workers regardless of race, creed, color, age, sex, national origin, religious persuasion or political affiliation
copyright 1999 - updated March 2005
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